How much does Medicare pay for CPT 95812?

Medicare allowed an average of $191.83 per service and paid $149.71 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $685.33, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95812?

Measurement of brain wave activity (eeg), 41-60 minutes. It was billed 17,253 times to 15,686 Medicare beneficiaries by 421 providers in 2024.

Does 95812 pay differently in an office than a hospital?

Yes. The allowed amount averaged $319.33 in an office setting and $55.55 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 95812 most?

Neurology, with 14,384 services from 392 clinicians. Next are Internal Medicine, Nurse Practitioner, General Practice.

CPT 95812

Measurement of brain wave activity (eeg), 41-60 minutes

$191.83Medicare-allowed amount per service, averaged across 17,253 services

Providers submitted

$685.33

Asking price, not received

Medicare allowed

$191.83

The fee schedule figure

Medicare paid

$149.71

Balance is patient coinsurance

Providers submitted an average of $685.33 for this code and Medicare allowed $191.83 — 3.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $149.71 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $319.33
Hospital / facility: $55.55

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 8,914 services were billed in an office setting and 8,339 in a facility.

Services: 17,253
Beneficiaries: 15,686
Providers billing it: 421
Total allowed: $3,309,643

What Medicare pays for CPT 95812

Across 17,253 services billed by 421 providers to 15,686 beneficiaries, Medicare allowed an average of $191.83 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95812

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	14,384	13,929	$179.28	392
Internal Medicine	1,186	806	$402.07	5
Nurse Practitioner	756	149	$43.58	4
General Practice	314	225	$375.15	1
Epileptologists	174	173	$311.48	5
Vascular Surgery	74	71	$53.66	2
Pediatric Medicine	65	64	$52.11	1
Family Practice	64	37	$298.43	1
Neuropsychiatry	54	54	$54.52	1
Psychiatry	51	51	$163.84	3
Critical Care (Intensivists)	28	27	$51.90	1
Audiologist	26	24	$56.61	1
Sleep Medicine	25	25	$49.57	1
Hospitalist	25	24	$58.10	1
Neurosurgery	16	16	$328.38	1

95812 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	3,273	$286.95	$197.08	32
Florida	1,301	$160.57	$124.85	41
Arizona	1,284	$248.15	$201.62	17
Nevada	1,280	$147.37	$119.14	12
New York	1,208	$286.02	$195.44	40
Tennessee	890	$120.57	$104.84	18
Texas	707	$220.49	$177.77	28
Illinois	622	$56.23	$41.88	23
Minnesota	587	$333.85	$241.03	17
New Jersey	574	$268.52	$189.37	19
Massachusetts	488	$58.90	$42.79	10
South Carolina	461	$189.59	$153.71	4
Connecticut	326	$70.32	$50.46	10
Utah	324	$53.26	$42.41	10
Michigan	280	$124.42	$97.24	8
Colorado	262	$54.68	$42.27	9
Washington	254	$54.19	$40.30	8
Pennsylvania	248	$143.43	$119.21	10
Georgia	246	$124.85	$101.79	11
West Virginia	225	$160.03	$149.95	8
Iowa	215	$52.52	$41.33	4
Maryland	206	$114.75	$88.38	8
New Mexico	185	$54.59	$41.61	8
Alaska	159	$329.90	$242.59	2
Nebraska	138	$52.80	$42.38	6
Delaware	136	$286.93	$223.11	2
Virginia	133	$77.32	$62.13	7
Oklahoma	113	$218.70	$203.98	1
Louisiana	111	$130.13	$115.76	5
New Hampshire	99	$53.83	$42.48	4
Missouri	95	$122.28	$92.67	6
Wisconsin	93	$101.34	$77.95	3
Alabama	86	$240.02	$212.50	3
Montana	80	$55.75	$40.81	3
Mississippi	80	$249.01	$227.67	2
Arkansas	79	$50.66	$42.61	1
Hawaii	78	$390.00	$274.74	1
North Dakota	70	$53.98	$40.59	4
North Carolina	44	$360.71	$253.13	2
Wyoming	33	$324.80	$265.85	2
Idaho	28	$53.96	$42.09	2
Kentucky	27	$50.45	$42.30	2
Vermont	25	$53.42	$35.89	1
Oregon	24	$55.83	$43.50	2
South Dakota	21	$53.52	$41.39	1
Ohio	16	$54.44	$40.86	1
Kansas	14	$53.40	$40.52	1
Puerto Rico	13	$57.69	$43.53	1
Indiana	12	$49.96	$44.37	1

Related codes

95886Needle measurement of electrical activity in arm or leg muscles$86.76
95816Measurement of brain wave activity (eeg)$227.96
95811Sleep study in sleep lab$314.61
95810Sleep study in sleep lab (6 years or older)$309.74
95800Sleep study including heart rate$117.17
95819Measurement of brain wave activity (eeg)$239.95
95885Needle measurement of electrical activity in arm or leg muscles$46.74
95806Sleep study including heart rate$54.06
95874Needle measurement of electrical activity in muscle$53.46
95861Needle measurement of electrical activity in arm or leg muscles$80.08
95870Needle measurement of electrical activity in arm$19.70
95813Measurement of brain wave activity (eeg)$202.49

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.